Skip to main page content
U.S. flag

An official website of the United States government

Dot gov

The .gov means it’s official.
Federal government websites often end in .gov or .mil. Before sharing sensitive information, make sure you’re on a federal government site.

Https

The site is secure.
The https:// ensures that you are connecting to the official website and that any information you provide is encrypted and transmitted securely.

Access keys NCBI Homepage MyNCBI Homepage Main Content Main Navigation
. 2022 Feb 10:2:805502.
doi: 10.3389/ffunb.2021.805502. eCollection 2021.

Herpes simplex Virus Pneumonitis in an Acute/Subacute Paracoccidioidomycosis Patient With Malabsorption Syndrome. Case-Report and Literature Review

Ricardo S Cavalcante  1 , Bruno S Souza  1 , Iverson X Duarte  2 , Marcelo P T Moraes  2 , Kunie I R Coelho  2 , Beatriz L Griva  3 , Beatriz A S Pereira  1 , Sueli A Calvi  1 , Marluci Betini  4 , Rinaldo P Mendes  1
Affiliations

Herpes simplex Virus Pneumonitis in an Acute/Subacute Paracoccidioidomycosis Patient With Malabsorption Syndrome. Case-Report and Literature Review

Ricardo S Cavalcante et al. Front Fungal Biol. .

Abstract

Paracoccidioides sp.-Herpes simplex virus (HSV) co-infection was not reported until now and malabsorption syndrome is a rare complication of the acute/subacute form (AF) of paracoccidioidomycosis (PCM), characterized by life-threatening abnormalities, such as fat and protein loss, lymphopenia, ascites, and intense immunosuppression. A 21-year-old woman presented the PCM AF with intense involvement of the abdominal and intestinal lymphoid organs, which leads to the malabsorption syndrome and severe immunosuppression. This patient developed a fatal-disseminated HSV infection associated with the paracoccidioidal disease. This case demonstrates that, in addition to the antigen-specific immunosuppression, some PCM patients can present a generalized cell-mediated immune depression and endogenous infection of latent microorganisms. On the best of our knowledge, this is the first report of an association between PCM and HSV infection.

Keywords: Herpes simplex pneumonitis; Paracoccidioides brasiliensis; herpetic infection and malnutrition; malnutrition; paracoccidioidomycosis; paracoccidioidomycosis-herpetic infection comorbidity.

PubMed Disclaimer

Conflict of interest statement

The authors declare that the research was conducted in the absence of any commercial or financial relationships that could be construed as a potential conflict of interest.

Figures

Figure 1
Figure 1
Sequential abdominal scintigraphy performed after the IV injection of 99mTc-albumin: protein loss was unequivocally visualized on small bowel projection at 5 h image (arrow) with progression to colon at 24 h image (arrowhead).
Figure 2
Figure 2
Paracoccidioidomycosis. (A) Lung. Epithelioid granuloma with multinucleated giant cells and yeast P. brasiliensis forms (H&E, ×200). (B) Colon. Epithelioid granuloma with multinucleated giant cells, and yeast P. brasiliensis forms (H&E, ×200). (C) Typical multiple-budding cell of P. brasiliensis seen in a GMS-stained (GMS, ×400).
Figure 3
Figure 3
(A) Herpetic pharyngitis: numerous intranuclear viral inclusions in squamous epithelial cells (H&E, ×200). (B) Herpetic necrotizing pneumonitis (H&E, ×200). (C) Intranuclear herpetic inclusions in a pneumocyte (H&E, ×400). (D) Herpes simplex (immunohistochemistry). Numerous cells are strongly immunostained for herpes antigen within cytoplasma (peroxidase antiperoxidase stain, ×200).
See this image and copyright information in PMC

Similar articles

See all similar articles

Cited by

References

    1. Andrade D. R., Hutzler R. U., Carvalho A. S., Rosenthal C., Carvalho M. A. B., Ferreira J. M. (1976). Hipoproteinemia em pacientes com paracoccidioidomicose do tubo digestivo e sistema linfático abdominal: revisão de casos de necropsia e apresentação de um caso com perda protéica digestiva. Rev. Hosp. Clín. Fac. Méd. Sau Paulo 31, 174–179. - PubMed
    1. Barker C. F., Billingham R. E. (1977). Immunologically privileged sites. Adv. Immunol. 25, 1–54. 10.1016/S0065-2776(08)60930-X - DOI - PubMed
    1. Benard G., Gryschek R. C. B., Duarte A. J. S., Shikanai-Yasuda M. A. (1996b). Cryptococcosis as an opportunistic infection in immunodeficiency secondary to paracoccidioidomycosis. Mycopathologia 133, 65–69. 10.1007/BF00439115 - DOI - PubMed
    1. Benard G., Hong M. A., Del Negro G. M. B., Batista L., Shikanai-Yasuda M. A., Duarte A. J. S. (1996a). Antigen-specific immunosuppression in paracoccidioidomycosis. Am J. Trop. Med. Hyg. 54, 7–12. 10.4269/ajtmh.1996.54.7 - DOI - PubMed
    1. Bettarello A., Magaldi C., Amato Netto V. (1972). Síndrome de malabsorção na blastomicose sul americana: relato de um caso. Rev. Hosp. Clín. Fac. Med. Sau Paulo 27, 245–250. - PubMed

LinkOut - more resources